Newsletter Europe 2009

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COUNCILOF EUROPE

CONSEILDE L’EUROPE

INTERNATIONAL FIGURES ON

DONATION AND TRANSPLANTATION - 2008

2009

NEWSLETTER

TRANSPLANTSEPTEMBER 2009

Vol. 14. Nº 1

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NEWSLETTER TRANSPLANT 14-09:aula medica 24/7/09 10:00 Página I

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AUSTRIAJacqueline Smits (ET)BELGIUMJacqueline Smits (ET)BULGARIADimitar BrunkovCYPRUSGeorge KyriakidesCZECH REPUBLICPavel BrezovskýDENMARKFrank Pedersen (SKT)ESTONIAPeeter DmitrievFINLANDFrank Pedersen (SKT)FRANCECristelle CantrelleFabienne PessioneGERMANYJacqueline Smits (ET)GREECEStratos ChatzixirosHUNGARYEszter Miskovits IRELANDFreda ONeill ITALYAndrea RicciLATVIABaltTransplantLITHUANIAVita AnulytèLUXEMBURGJacqueline Smits (ET)MALTANETHERLANDSJacqueline Smits (ET)POLANDJaroslaw CzerwinskiPORTUGALMaria João AguiarROMANIARosana TURCUSLOVAKIALudovit LacaSLOVENIAJacqueline Smits (ET)

SPAINCarmen MartinManuel SerranoDavid UruñuelaSilvia MartinSWEDENFrank Pedersen (SKT)UNITED KINGDOM Toyab Hussain

(ET) EUROTRANSPLANT Austria, Bel-gium, Croatia, Germany, Luxemburg,Netherlands, Slovenia

(SKT) SCANDIATRANSPLANTDenmark, Finland, Norway, Sweden,Iceland

AUSTRALIALee ExcellCANADAMarianne TangCROATIAJacqueline Smits (ET)GEORGIAGia TomadzeICELANDFrank Pedersen (SKT)ISRAELTamar AshkenaziMOLDOVAIgor CodreanuNEW ZEALANDLee ExcellNORWAYFrank Pedersen (SKT)SWITZERLANDFranziska BeyelerTURKEYNuran ERDENUSAwww.unos.org

ARGENTINAMartín Alejandro TorresRicardo Rubén Ibarwww.grupopuntacana.org

BOLIVIAAna Claudia Pachecowww.grupopuntacana.orgBRASILwww.grupopuntacana.orgCHILEwww.grupopuntacana.orgCOLOMBIAJuan Gonzalo López Casaswww.grupopuntacana.orgCOSTA RICACUBAJuan Alberto Falcón AlvarezJuan Carlos Michelenawww.grupopuntacana.orgDOMINICANAwww.grupopuntacana.orgECUADOREL SALVADORRaúl Armando Palomo EscobarGUATEMALARudolf A. García-Gallontwww.grupopuntacana.orgHONDURASMEXICOEnrique Martínez GutiérrezOmar Sánchez RamírezNICARAGUAPANAMADavid CrespoPARAGUAYHugo A. Espinoza C.PERUURUGUAYInés AlvarezRaul José Mizrajiwww.grupopuntacana.orgVENEZUELACarmen Luisa Lattuf de Milanéswww.grupopuntacana.org

GRUPO PUNTA CANAArgentina, Bolivia, Brasil, Chile, Colombia, Costa Rica, Cuba, Dominicana, Ecuador, El Salvador, España, Guatemala, Honduras, México,Nicaragua, Panamá, Paraguay, Perú,Portugal, Puerto Rico, Uruguay y Venezuelawww.grupopuntacana.org

INTERNATIONAL FIGURES ON ORGAN, TISSUE & HEMATOPOIETIC STEM CELL DONATION

& TRANSPLANTATION ACTIVITIES. DOCUMENTS PRODUCED BY THE COMMITTEE

OF EXPERTS ON THE ORGANISATIONAL ASPECTS OF CO-OPERATION IN ORGAN TRANSPLANTATION (2008)

Editor: Rafael Matesanz

NATIONAL DATA PROVIDED BY:

Organización Nacional de Trasplantes (ONT) – SpainRafael MatesanzBeatriz MahilloMarina Alvarez

Foot Note: For the purposes of this Newsletter the following definitions were used:Organ donor: Every potential donor transferred to the operating theatre from whom, at least, one solid organ has been retrievedMultiorgan donor: Every donor from whom, at least, two different solid organs have been retrievedAbsolute number: Include all figures corresponding to all donors/patients adults and childrenPaediatric: Includes only paediatric activity (patients under 15 years old)

AULA MÉDICA EDICIONES. Isabel Colbrand, 10-12 - 2ª planta. 28050 Madrid (España)Tel. 91 358 64 78. Fax 91 358 99 79. Depósito legal: M-9.990-1996

NEWSLETTER TRANSPLANT 14-09:aula medica 24/7/09 10:00 Página II

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NEWSLETTER

TRANSPLANT 2009

• INTERNATIONAL FIGURES ON DONATION AND TRANSPLANTATION ACTIVITY. YEAR 2008 ........................... 3

• INTERNATIONAL DATA ON ORGAN DONATION AND TRANSPLANTATION ACTIVITY, WAITING LIST

AND FAMILY REFUSALS. YEAR 2008 ................................................................................................... 25

• INTERNATIONAL DATA ON TISSUES AND HEMATOPOIETIC STEM CELL DONATION AND

TRANSPLANTATION ACTIVITY. YEAR 2008 ............................................................................................. 39

• “THE DECLARATION OF ISTANBUL ON ORGAN TRAFFICKING AND TRANSPLANT TOURISM”. YEAR 2008 ... 49

CONTENTS

NEWSLETTER TRANSPLANT 14-09:aula medica 24/7/09 10:00 Página 1

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COUNCILOF EUROPE


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International Figures onDonation and

Transplantation Activity.Year 2008

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International Data on OrganDonation and Transplantation Activity,

Waiting List and Family Refusals.Year 2008

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0.9)

8 (1

.1)

24 (3

4.0)

297

(28.

6)12

1 (2

2.0)

54 (4

1.5)

141

(26.

5)26

17 (4

1.1)

2169

(26.

4)-D

oubl

e TX

(pm

p)0

6 (0

.6)

0-

8 (0

.8)

1 (0

.2)

00

46 (0

.7)

19 (0

.2)

Livi

ng T

X (p

mp)

58 (7

.0)

45 (4

.2)

11 (1

.5)

34 (4

8.6)

29 (2

.8)

74 (1

3.5)

3 (2

.3)

9 (1

.7)

222

(3.5

)56

5 (6

.9)

NH

B k

idne

y TX

(pm

p)12

(1.4

)53

(5.0

)0

-1

(0.1

)-

0-

52 (0

.8)

0

LIVE

RTX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)11

6 (1

3.9)

230

(21.

6)9

(1.2

)-

97 (9

.3)

44 (8

.0)

2 (1

.5)

47 (8

.8)

1011

(15.

9)11

22 (1

3.7)

Pae

diat

ric <

15 y

ears

832

0-

46

-5

6310

9-S

plit

Live

r TX

(pm

p)1

(0.1

)18

(1.7

)0

-0

0-

095

(1.5

)89

(1.1

)-D

omin

o Li

ver

TX(p

mp)

00

0-

00

-0

11 (0

.2)

7 (0

.1)

Livi

ng L

iver

TX

(pm

p)4

(0.5

)13

(1.2

)4

(0.5

)-

00

-0

10 (0

.2)

55 (0

.7)

NH

B L

iver

TX

(pm

p)1

(0.1

)17

(1.6

)0

-0

--

-0

0

HE

AR

TTX

-in

clud

ed H

eart

-Lun

g tra

nspl

ant-

(pm

p)62

(7.4

)75

(7.0

)3

(0.4

)-

59 (5

.7)

20 (3

.6)

-21

(3.9

)37

9 (6

.0)

382

(4.7

)P

aedi

atric

<15

yea

rs2

20

-1

1-

313

17

HE

AR

T-LU

NG

Tran

spla

nts

(pm

p)3

(0.4

)1

(0.1

)0

-0

0-

019

(0.3

)19

(0.2

)P

aedi

atric

<15

yea

rs-

-0

-0

0-

01

1

LUN

GTX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)11

9 (1

4.3)

82 (7

.7)

0-

20 (1

.9)

18 (3

.3)

-12

(2.3

)21

5 (3

.4)

270

(3.3

)P

aedi

atric

<15

yea

rs6

20

-0

0-

06

4-S

ingl

e (p

mp)

13 (1

.6)

15 (1

.4)

0-

6 (0

.6)

5 (0

.9)

-0

53 (0

.8)

40 (0

.5)

-Dou

ble

- in

clud

ed H

eart

-Lun

g TX

- (p

mp)

106

(12.

7)67

(6.3

)0

-14

(1.3

)13

(2.4

)-

12 (2

.3)

162

(2.5

)23

0 (2

.8)

NH

B –

dou

ble

+ si

ngle

- L

ung

TX (p

mp)

-4

(0.4

)0

-0

--

-0

0

PAN

CR

EA

STX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)34

(4.1

)18

(1.7

)0

-26

(2.5

)-

--

81 (1

.3)

134

(1.6

)P

aedi

atric

<15

yea

rs0

00

-0

--

-0

0-K

idne

y -

Pan

crea

s TX

(pm

p)31

(3.7

)16

(1.5

)0

-23

(2.2

)-

--

73 (1

.1)

121

(1.5

)-P

ancr

eas

TX A

lone

(pm

p)3

(0.4

)2

(0.2

)0

-3

(0.3

)-

--

8 (0

.1)

13 (0

.2)

SMA

LL B

OW

EL

TX –

incl

uded

all

the

com

bina

tions

- (p

mp)

--

0-

0-

--

13 (0

.2))

-P

aedi

atric

<15

yea

rs-

-0

-0

--

-7

--L

iver

+ S

mal

l Bow

el (p

mp)

--

0-

0-

--

3 (0

.1)

--S

. B. T

X A

lone

(pm

p)-

-0

-0

--

-9

(0.1

)-

MU

LTIV

ISC

ER

AL

(pm

p)-

-0

--

--

-1

(0.0

)-


27

�

�

� �

�

�

�

�

�

� �

DO

NAT

ION

AN

D T

RA

NSP

LAN

TATI

ON

AC

TIVI

TY

EUR

OP

EAN

UN

ION

CO

UN

TRIE

SC

OU

NTR

IES

GR

EEC

EH

UN

GA

RY

IREL

AN

DIT

ALY

LATV

IALI

THU

AN

IALU

XEM

BOUR

GM

ALT

ANE

THER

LAND

SP

OLA

ND

Pop

ulat

ion

(mill

ion

inha

bita

nts)

11.0

10.1

4.4

56.9

2.3

3.4

0.5

0.4

16.4

38.1

DO

NAT

ION

Dec

ease

d O

rgan

D. -

incl

uded

NH

BD

- (p

mp)

98 (8

.9)

148

(14.

7)81

(18.

4)12

01 (2

1.1)

30 (1

3.0)

33 (9

.7)

9 (1

8.6)

-21

0 (1

2.8)

427

(11.

2)N

HB

Don

ors

(pm

p)-

-0

3 (0

.1)

11 (4

.8)

--

-91

(5.6

)0

% M

ultio

rgan

don

ors

79.6

41.2

5880

.30.

430

.310

0-

78.1

56

TRA

NSP

LAN

TATI

ON

KID

NE

YTX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)23

7 (2

1.5)

259

(25.

7)14

6 (3

3.2)

1656

(29.

1)54

(23.

5)51

(15.

0)3

(6.2

)-

763

(46.

5)81

0 (2

1.2)

% (L

ivin

g TX

/ To

tal T

X)21

.510

.26.

97.

41.

99.

80

-34

.02.

5P

aedi

atric

<15

yea

rs2

74

390

20

-53

.931

Dec

ease

d D

onor

TX

(pm

p)18

6 (1

6.9)

235

(23.

3)13

6 (3

0.9)

1533

(26.

9)53

(23.

0)46

(13.

5)3

(6.2

)-

352

(21.

5)79

0 (2

0.7)

-Sin

gle

TX (p

mp)

186

(16.

9)23

5 (2

3.3)

129

(29.

3)14

21 (2

5.0)

53 (2

3.0)

46 (1

3.5)

3 (6

.2)

-34

8 (2

1.2)

790

(20.

7)-D

oubl

e TX

(pm

p)0

07

(1.6

)11

2 (2

.0)

0-

0-

4 (0

.2)

0Li

ving

TX

(pm

p)51

(4.6

)24

(2.4

)10

(2.3

)12

3 (2

.2)

1 (0

.4)

5 (1

.5)

0-

411

(25.

1)20

(0.5

)N

HB

kid

ney

TX (p

mp)

0-

03

(0.1

)20

(8.3

)-

0-

135

(8.2

)0

LIVE

RTX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)58

(5.3

)36

(3.6

)58

(13.

2)10

15 (1

7.8)

06

(1.8

)0

-13

1 (8

.0)

245

(6.4

)P

aedi

atric

<15

yea

rs0

20

650

-0

-9

31-S

plit

Live

r TX

(pm

p)0

0-

92 (1

.6)

0-

0-

8 (0

.5)

0-D

omin

o Li

ver

TX(p

mp)

0-

-4

(0.1

)0

-0

-0

0Li

ving

Liv

er T

X (p

mp)

00

-19

(0.3

)0

-0

-2

(0.1

)21

(0.6

)N

HB

Liv

er T

X (p

mp)

0-

--

0-

0-

29 (1

.8)

0

HE

AR

TTX

-in

clud

ed H

eart

-Lun

g tr

ansp

lant

- (p

mp)

16 (1

.5)

22 (2

.2)

4 (0

.9)

326

(5.7

)0

5 (1

.5)

0-

32 (1

.6)

61 (1

.6)

Pae

diat

ric <

15 y

ears

02

-14

02

0-

46

HE

AR

T-LU

NG

Tran

spla

nts

(pm

p)0

-0

2 (0

.0)

0-

0-

1 (0

.1)

0P

aedi

atric

<15

yea

rs0

-0

-0

-0

--

0

LUN

GTX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)3

(0.3

)-

4 (0

.9)

94 (1

.6)

02

(0.6

)0

-56

(3.4

)11

(0.3

)P

aedi

atric

<15

yea

rs0

--

-0

-0

-3

0-S

ingl

e (p

mp)

2 (0

.2)

--

31 (0

.5)

0-

0-

14 (0

.9)

8 (0

.2)

-Dou

ble

- in

clud

ed H

eart

-Lun

g TX

- (p

mp)

1 (0

.1)

--

63 (1

.1)

02

(0.6

)0

-42

(2.6

)3

(0.1

)N

HB

– d

oubl

e +

sing

le -

Lun

g TX

(pm

p)0

-0

-0

-0

-12

(0.7

)0

PAN

CR

EA

STX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)2

(0.2

)5

(0.5

)12

(2.7

)61

(1.1

)1

(0.4

)4

(1.2

)0

-14

(0.9

)20

(0.5

)P

aedi

atric

<15

yea

rs-

0-

-0

-0

-0

0-K

idne

y -

Pan

crea

s TX

(pm

p)2

(0.2

)5

(0.5

)12

(2.7

)47

(0.8

)1

(0.4

)4

(1.2

)0

-12

(0.7

)20

(0.5

)-P

ancr

eas

TX A

lone

(pm

p)0

00

12 (0

.2)

0-

0-

2 (0

.1)

0

SMA

LL B

OW

EL

TX –

incl

uded

all

the

com

bina

tions

- (p

mp)

0-

03

(0.1

)0

-0

--

0P

aedi

atric

<15

yea

rs-

-0

10

-0

--

0-L

iver

+ S

mal

l Bow

el (p

mp)

--

0-

0-

0-

-0

-S. B

. TX

Alo

ne (p

mp)

--

03

(0.1

)0

-0

--

0

MU

LTIV

ISC

ER

AL

(pm

p)0

-0

-0

-0

--

0


28

�

�

� �

�

�

�

�

�

� �

DO

NAT

ION

AN

D T

RA

NSP

LAN

TATI

ON

AC

TIVI

TY

EUR

OP

EAN

UN

ION

CO

UN

TRIE

SO

THER

CO

UN

TRIE

SC

OU

NTR

IES

PO

RTU

GA

LR

OM

AN

IASL

OVA

KIA

SLO

VEN

IASP

AIN

SWED

ENU

. K.

AU

STR

ALI

AC

AN

AD

AC

RO

AC

IAP

opul

atio

n (m

illio

n in

habi

tant

s)10

.621

5.3

2.0

46.2

9.2

60.2

21.4

33.3

4.4

DO

NAT

ION

Dec

ease

d O

rgan

D. -

incl

uded

NH

BD

- (p

mp)

283

(26.

7)60

(2.9

)77

(18.

4)37

(18.

3)15

77 (3

4.2)

152

(16.

5)88

5 (1

4.7)

259

(12.

1)48

6 (1

4.6)

83 (1

8.7)

NH

B D

onor

s (p

mp)

01

(0.0

)0

-77

(1.7

)-

264

(4.4

)23

(1.1

)40

(1.2

)-

% M

ultio

rgan

don

ors

73.9

6048

81.1

8485

77.2

81-

83.1

TRA

NSP

LAN

TATI

ON

KID

NE

YTX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)52

4 (4

9.4)

227

(10.

8)16

6 (3

1.3)

52 (2

5.7)

2229

(48.

3)41

9 (4

5.5)

2302

(38.

2)77

6 (3

6.3)

1204

(36.

2)15

8 (3

5.6)

% (L

ivin

g TX

/ To

tal T

X)9.

349

.312

.70

7.0

32.5

37.1

43.2

537

.15.

7P

aedi

atric

<15

yea

rs15

172

062

1110

415

-4

Dec

ease

d D

onor

TX

(pm

p)47

5 (4

4.8)

115

(5.5

)14

5 (2

7.3)

52 (2

5.7)

2073

(44.

9)28

3 (3

0.7)

1382

(23.

0)42

4 (1

9.8)

730

(21.

9)14

9 (3

3.6)

-Sin

gle

TX (p

mp)

469

(44.

2)11

4 (5

.4)

143

(27)

52 (2

5.7)

2050

(44.

4)27

7 (3

0.1)

1378

(22.

9)42

2 (1

9.7)

703

(21.

1)14

8 (3

3.4)

-Dou

ble

TX (p

mp)

6 (0

.6)

1 (0

.0)

2 (0

.3)

023

(0.5

)6

(0.7

)4

(0.1

)2

(0.1

)27

(0.8

)1

(0.2

)Li

ving

TX

(pm

p)49

(4.6

)11

2 (5

.3)

21 (3

.9)

015

6 (3

.4)

136

(14.

8)92

0 (1

5.3)

352

(16.

4)47

4 (1

4.2)

9 (2

.0)

NH

B k

idne

y TX

(pm

p)0

2 (0

.1)

00

105

(2.3

)-

454

(7.5

)43

(2.0

)68

(2.0

)0

LIVE

RTX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)27

4 (2

5.8)

43 (2

.1)

12 (2

.2)

22 (1

0.9)

1108

(24.

0)14

6 (1

5.8)

719

(11.

9)19

5 (9

.1)

545

(13.

6)65

(14.

7)P

aedi

atric

<15

yea

rs14

3-

067

610

66

-0

-Spl

it Li

ver

TX (p

mp)

4 (0

.4)

00

022

(0.5

)1

(0.1

)14

3 (2

.4)

35 (1

.6)

11 (0

.3)

0-D

omin

o Li

ver

TX(p

mp)

70 (6

.6)

00

014

(0.3

)7

(0.8

)8

(0.1

)-

-0

Livi

ng L

iver

TX

(pm

p)5

(0.5

)8

(0.4

)0

028

(0.6

)6

(0.6

)36

(0.6

)3

(0.1

)67

(2.0

)1

(0.2

)N

HB

Liv

er T

X (p

mp)

00

00

14 (0

.3)

-86

(1.4

)4

(0.2

)16

(0.5

)0

HE

AR

TTX

-in

clud

ed H

eart

-Lun

g tr

ansp

lant

- (p

mp)

42 (3

.9)

6 (0

.3)

26 (4

.9)

6 (3

.0)

292

(6.3

)45

(4.9

)12

7 (2

.1)

85 (3

.9)

168

(5.0

)20

(4.5

)P

aedi

atric

<15

yea

rs3

01

021

625

2-

-

HE

AR

T-LU

NG

Tran

spla

nts

(pm

p)0

00

-4

(0.1

)1

(0.1

)5

(0.1

)5

(0.2

)4

(0.1

)-

Pae

diat

ric <

15 y

ears

00

--

--

1-

--

LUN

GTX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)4

(0.4

)0

0-

192

(4.2

)52

(5.6

)13

9 (2

.3)

115

(5.4

)13

5 (4

.1)

-P

aedi

atric

<15

yea

rs0

0-

-6

-6

4-

--S

ingl

e (p

mp)

1 (0

.1)

00

-90

(1.9

)27

(2.9

)28

(0.5

)11

(0.5

)31

(0.9

)-

-Dou

ble

- in

clud

ed H

eart

-Lun

g TX

- (p

mp)

3 (0

.3)

00

-10

2 (2

.2)

25 (2

.7)

111

(1.8

)10

4 (4

.9)

104

(3.1

)-

NH

B –

dou

ble

+ si

ngle

- L

ung

TX (p

mp)

00

0-

5 (0

.1)

-12

(0.2

)7

(0.3

)4

(0.1

)-

PAN

CR

EA

STX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)14

(1.3

)0

0-

104

(2.3

)10

(1.1

)21

6 (3

.6)

32 (1

.5)

85 (2

.6)

14 (3

.2)

Pae

diat

ric <

15 y

ears

00

--

4-

71

-0

-Kid

ney

- P

ancr

eas

TX (p

mp)

10 (0

.9)

00

-89

(1.9

)10

(1.1

)16

2 (2

.7)

32 (1

.5)

64 (1

.9)

14 (3

.2)

-Pan

crea

s TX

Alo

ne (p

mp)

4 (0

.4)

00

-15

(0.3

)-

54 (0

.9)

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(0.6

)-

SMA

LL B

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incl

uded

all

the

com

bina

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- (p

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00

0-

14 (0

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--

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l Bow

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(pm

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00

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571

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DO

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Dec

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d O

rgan

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incl

uded

NH

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02

(6.3

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(9.8

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31 (7

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98 (2

0.5)

90 (1

1.8)

262

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84 (2

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NH

B D

onor

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mp)

0-

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2 (0

.5)

-0

3 (0

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-%

Mul

tiorg

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onor

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100

79.2

081

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96.9

-

TRA

NSP

LAN

TATI

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KID

NE

YTX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)7

(1.6

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(15.

6)14

2 (1

9.4)

012

1 (2

8.3)

278

(58.

1)28

6 (3

8.0)

1662

(23.

2)16

517

(54.

4)%

(Liv

ing

TX/

Tota

l TX)

100

100

39.4

056

.235

.340

.675

.136

.1P

aedi

atric

<15

yea

rs0

-17

02

39

-77

3D

ecea

sed

Don

or T

X (p

mp)

0-

86 (1

1.7)

053

(12.

4)18

0 (3

7.6)

170

(22.

6)41

4 (5

.7)

1055

0 (3

4.7)

-Sin

gle

TX (p

mp)

0-

85 (1

1.6)

0-

178

(37.

1)16

9 (2

2.5)

412

(5.7

)-

-Dou

ble

TX (p

mp)

0-

1 (0

.1)

0-

2 (0

.5)

1 (0

.1)

2 (0

.0)

-Li

ving

TX

(pm

p)7

(1.6

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(15.

6)56

(7.6

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68 (1

5.9)

98 (2

0.5)

116

(15.

4)12

48 (1

7.4)

5967

(19.

6)N

HB

kid

ney

TX (p

mp)

0-

-0

4 (0

.9)

-0

6 (0

.1)

-

LIVE

RTX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)0

5 (1

5.6)

56 (7

.6)

024

(5.6

)79

(16.

5)83

(11.

0)60

2 (8

.4)

6318

(20.

8)P

aedi

atric

<15

yea

rs0

100

80

17

8-

613

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it Li

ver

TX (p

mp)

0-

1 (0

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03

(0.7

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(0.6

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Live

r TX

(pm

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0-

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Liv

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05

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7 (1

.6)

012

(1.6

)39

0 (5

.4)

249

(0.8

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HB

Liv

er T

X (p

mp)

0-

-0

--

-0

-

HE

AR

TTX

-in

clud

ed H

eart

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g tr

ansp

lant

- (p

mp)

0-

20 (2

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010

(2.3

)39

(8.1

)29

(3.8

)51

(0.7

)21

63 (7

.1)

Pae

diat

ric <

15 y

ears

0-

30

01

-8

365

HE

AR

T-LU

NG

Tran

spla

nts

(pm

p)0

-1

(0.1

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(0.6

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1 (0

.0)

27 (0

.1)

Pae

diat

ric <

15 y

ears

0-

-0

-0

-6

LUN

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– in

clud

ed a

ll th

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mbi

natio

ns -

(pm

p)0

-51

(7.0

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14 (3

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30 (6

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40 (5

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1 (0

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1478

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045

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(pm

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29 (6

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34 (4

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sing

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p)0

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0-

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0-

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CR

EA

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clud

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ll th

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mbi

natio

ns -

(pm

p)0

-11

(1.5

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4 (0

.9)

10 (2

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17 (2

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10 (0

.1)

1273

(4.2

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aedi

atric

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yea

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--

01

0-

069

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ney

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ancr

eas

TX (p

mp)

0-

11 (1

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04

(0.9

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(1.9

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(0.0

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7 (2

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0-

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6 (1

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SMA

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TX –

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uded

all

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bina

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- (p

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0-

1 (0

.1)

0-

-1

(0.1

)3

(0.0

)18

5 (0

.6)

Pae

diat

ric <

15 y

ears

0-

10

--

-0

93-L

iver

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mal

l Bow

el (p

mp)

0-

1 (0

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0-

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0-

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mp)

0-

1 (0

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0-

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5 (0

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DO

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Dec

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d O

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519

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31 (7

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119

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26.8

--

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TRA

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NE

YTX

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clud

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ll th

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(pm

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79 (8

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3780

(20.

5)20

6 (1

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705

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144

(12.

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29 (5

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.9-

--

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693

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100

Pae

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ric <

15 y

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70-

--

--

1-

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Dec

ease

d D

onor

TX

(pm

p)75

3 (1

8.9)

38 (4

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2033

(11.

0)20

6 (1

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641

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136

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1)7

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0-S

ingl

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(pm

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6 (1

8.7)

--

--

-13

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2.1)

--

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(pm

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(0.2

)-

--

--

--

--

Livi

ng T

X (p

mp)

207

(5.2

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(4.5

)17

47 (9

.5)

-64

(1.3

)-

8 (0

.7)

95 (1

0.0)

-29

(5.1

)N

HB

kid

ney

TX (p

mp)

--

--

--

--

--

LIVE

RTX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)28

0 (7

.0)

-10

53 (5

.7)

74 (4

.4)

198

(4.1

)-

28 (2

.5)

1 (0

.1)

-0

Pae

diat

ric <

15 y

ears

65-

--

--

2-

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-Spl

it Li

ver

TX (p

mp)

12 (0

.3)

--

--

--

--

--D

omin

o Li

ver

TX(p

mp)

--

--

--

--

--

Livi

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TX

(pm

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(0.8

)-

--

--

--

--

NH

B L

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TX

(pm

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--

--

--

--

-

HE

AR

TTX

-in

clud

ed H

eart

-Lun

g tr

ansp

lant

- (p

mp)

100

(2.5

)-

200

(1.1

)19

(1.1

)83

(1.7

)-

3 (0

.3)

--

0P

aedi

atric

<15

yea

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--

--

--

--

0

HE

AR

T-LU

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Tran

spla

nts

(pm

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(0.1

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--

--

--

-0

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diat

ric <

15 y

ears

1-

--

--

--

-0

LUN

GTX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)32

(0.8

)-

53 (0

.3)

9 (0

.5)

14 (0

.3)

--

--

0P

aedi

atric

<15

yea

rs1

--

--

--

--

0-S

ingl

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mp)

16 (0

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--

--

--

--

--D

oubl

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incl

uded

Hea

rt-L

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TX -

(pm

p)16

(0.4

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--

--

--

--

NH

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dou

ble

+ si

ngle

- L

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TX (p

mp)

--

--

--

--

--

PAN

CR

EA

STX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)85

(2.1

)-

--

--

1 (0

.1)

--

0P

aedi

atric

<15

yea

rs-

--

--

--

--

0-K

idne

y -

Pan

crea

s TX

(pm

p)77

(1.9

)-

32 (0

.2)

-5

(0.1

)-

1 (0

.1)

--

--P

ancr

eas

TX A

lone

(pm

p)8

(0.2

)-

--

--

--

--

SMA

LL B

OW

EL

TX –

incl

uded

all

the

com

bina

tions

- (p

mp)

8 (0

.2)

--

--

--

--

0P

aedi

atric

<15

yea

rs6

--

--

--

--

0-L

iver

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mal

l Bow

el (p

mp)

2 (0

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--

--

--

--

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lone

(pm

p)5

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--

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5.7

3.3

5.2

28.8

3.3

27.9

DO

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Dec

ease

d O

rgan

D. -

incl

uded

NH

BD

- (p

mp)

7 (0

.6)

-33

2 (3

.1)

-6

(1.8

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(2.1

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63 (1

9.1)

93 (3

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NH

B D

onor

s (p

mp)

--

--

00

-0

0%

Mul

tiorg

an d

onor

s-

-33

.6-

00

-80

.92

TRA

NSP

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TATI

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KID

NE

YTX

– in

clud

ed a

ll th

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mbi

natio

ns -

(pm

p)85

(6.3

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2260

(21.

8)-

24 (7

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27 (5

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-12

1 (3

6.7)

278

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Tota

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83.5

-75

.14

-50

.077

.8-

36.0

Pae

diat

ric <

15 y

ears

--

255

-0

0-

-29

Dec

ease

d D

onor

TX

(pm

p)14

(1.1

)-

562

(5.3

)-

12 (3

.6)

6 (1

.2)

-11

4 (3

4.5)

178

(6.4

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ingl

e TX

(pm

p)12

(0.9

)-

556

(5.2

)-

12 (3

.6)

6 (1

.2)

--

178

(6.4

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oubl

e TX

(pm

p)1

(0.1

)-

6 (0

.1)

-0

0-

-0

Livi

ng T

X (p

mp)

71 (5

.3)

-16

98 (1

5.9)

-12

(3.6

)21

(4.0

)-

7 (2

.1)

100

(3.6

)N

HB

kid

ney

TX (p

mp)

--

--

00

--

0

LIVE

RTX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)-

-96

(0.9

)-

-0

-3

(0.9

)10

(0.4

)P

aedi

atric

<15

yea

rs-

-8

--

0-

-5

-Spl

it Li

ver

TX (p

mp)

--

--

-0

--

2 (0

.1)

-Dom

ino

Live

r TX

(pm

p)-

-0

--

0-

-0

Livi

ng L

iver

TX

(pm

p)-

-8

(0.1

)-

-0

--

8 (0

.3)

NH

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iver

TX

(pm

p)-

-0

--

0-

-0

HE

AR

TTX

-in

clud

ed H

eart

-Lun

g tr

ansp

lant

- (p

mp)

--

14 (0

.1)

--

1 (0

.2)

-11

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Pae

diat

ric <

15 y

ears

--

2-

-0

-0

0

HE

AR

T-LU

NG

Tran

spla

nts

(pm

p)-

--

--

0-

-0

Pae

diat

ric <

15 y

ears

--

--

-0

--

0

LUN

GTX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)-

-1

(0.0

)-

-0

-4

(1.2

)0

Pae

diat

ric <

15 y

ears

--

--

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--

0-S

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mp)

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1 (0

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--

0-

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ble

- in

clud

ed H

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g TX

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mp)

--

--

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sing

le -

Lun

g TX

(pm

p)-

--

--

0-

-0

PAN

CR

EA

STX

– in

clud

ed a

ll th

e co

mbi

natio

ns -

(pm

p)-

-1

(0.0

)-

-0

-6

(1.8

)0

Pae

diat

ric <

15 y

ears

--

--

-0

-0

0-K

idne

y -

Pan

crea

s TX

(pm

p)-

-1

(0.0

)-

-0

-6

(1.8

)0

-Pan

crea

s TX

Alo

ne (p

mp)

--

--

0-

-0

SMA

LL B

OW

EL

TX –

incl

uded

all

the

com

bina

tions

- (p

mp)

--

--

-1

(0.2

)-

-0

Pae

diat

ric <

15 y

ears

--

--

-0

--

0-L

iver

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mal

l Bow

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mp)

--

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0-S

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51.

35.

363

.682

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KID

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CEN

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74

11

44-

Pat

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ring

2008

365

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3529

443

206

5425

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by

2008

, 31st

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883

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111

546

489

6339

868

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2008

3918

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2008

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Pat

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2008

149

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432

3813

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2008

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113

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Pat

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2008

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2008

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5943

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2008

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Pat

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2008

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Pat

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ring

2008

225

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2609

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Pat

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2008

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2008

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2008

1725

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733

--

5420

4P

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2008

17

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10

113

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Pat

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2008

514

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Pat

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03

--

185

20P

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L du

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2008

12

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0-

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285

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CR

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02

113

11

--

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Pat

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2008

-4

1170

212

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Pat

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s aw

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TX b

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08, 3

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62

11-

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15P

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2008

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--

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by

2008

, 31st

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85

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Pat

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2008

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by

2008

, 31st

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2275

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294

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2008

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2008

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by

2008

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587

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2008

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158

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42

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75

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Pat

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2008

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Pat

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2008

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2008

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13

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2008

1335

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2008

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2008

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Pat

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2008

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2008

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2008

1500

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2008

--

108

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by

2008

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131

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2008

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530

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Pat

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2008

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2008

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2008

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2008

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2008

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Pat

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2008

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2008

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2008

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2008

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2008

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2008

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109

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2008

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2008

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2008

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2008

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2008

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2008

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Pat

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2008

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Pat

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2008

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International Data on Tissue and Hematopoietic Stem Cell

Donation and Transplantation Activity.Year 2008

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COUNCILOF EUROPE



40

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AUSTRIAJohann KurzBELGIUMMuylle LudoBULGARIADimitar BrunkowCYPRUSCZECH REPUBLICPavel BrezovskýJana SikorováEva KremenováDENMARKESTONIAFINLANDFRANCEArnaud De GuerraFenzi TeskratGERMANYJohanna StrobelRalf TönjesGREECEAthina GompouHUNGARYIRELANDITALYFiorenza BarianiLetizia LombardiniSimonetta PupellaGiulia ScaravelliLATVIAAnita DaugavvanagaLITHUANIADainora MedeisieneLUXEMBURGMALTANETHERLANDSPOLANDArtur KaminskiPORTUGALMargarida Amil DiazCarlos Calhaz JorgeROMANIARosana TurcuSLOVAKIAJan Koller

SLOVENIAGorazd Cebulc Andrijana TivadarSabina LobeSPAINRosario MarazuelaMarina AlvarezSWEDENCamilla OlofssonUNITED KINGDOM Sandy MatherTrish Davies

AUSTRALIACANADACROATIAMirela BusicGEORGIAICELANDISRAELMACEDONIANEW ZEALANDNORWAYVibeke DalenSWITZERLANDTURKEYZeynep CoskunUSA

ARGENTINAMartín Alejandro TorresRicardo Rubén Ibarwww.grupopuntacana.orgBOLIVIABRASILwww.grupopuntacana.orgCHILECOLOMBIAJuan Gonzalo López CasasCOSTA RICACUBAJuan Alberto Falcón AlvarezJuan Carlos Michelenawww.grupopuntacana.orgDOMINICANAwww.grupopuntacana.orgECUADOREL SALVADORRaúl Armando Palomo EscobarGUATEMALAHONDURASMEXICOEnrique Martínez GutiérrezOmar Sánchez RamírezNICARAGUAPANAMADavid CrespoPARAGUAYHugo A. Espinoza C.PERUURUGUAYInés AlvarezRaúl José Mizrajiwww.grupopuntacana.orgVENEZUELACarmen Luisa Lattuf de Milanéswww.grupopuntacana.org

TISSUE & HEMATOPOIETIC STEM CELL NATIONAL DATA PROVIDED BY:

Data recorded & prepared by: EUROCET - European Registry of Competent Authorities for Tissues and Cells - Team (www.eurocet.org)


41

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611

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1156

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4123

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769

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Data

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2008

NO D

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2008

NO D

ATA

NO D

ATA

NO D

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2008

2008

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OF

DATA

TYPE

OF

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S

N° o

f don

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Aut

olog

ous

1.26

416

.498

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MAR

ROW

5CO

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239

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N° o

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1.08

610

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PERI

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PERI

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N° o

f tra

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356

2.95

13.

961

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MAR

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130,

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MAR

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f tra

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nic

151

2525

61.

472

2.04

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543

70

CORD

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10

246

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MAR

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N° o

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1034

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524

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115

222

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324

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305

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611.

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PERI

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218

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133

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“The Declaration of Istanbulon Organ Trafficking and

Transplant Tourism”.Year 2008

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COUNCILOF EUROPE



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PREAMBLE

Organ transplantation, one of the medical miraclesof the twentieth century, has prolonged andimproved the lives of hundreds of thousands ofpatients worldwide. The many great scientific andclinical advances of dedicated healthprofessionals, as well as countless acts ofgenerosity by organ donors and their families, havemade transplantation not only a life-saving therapybut a shining symbol of human solidarity. Yet theseaccomplishments have been tarnished bynumerous reports of trafficking in human beingswho are used as sources of organs and of patient-tourists from rich countries who travel abroad topurchase organs from poor people. In 2004, theWorld Health Organization, called on memberstates “to take measures to protect the poorestand vulnerable groups from transplant tourism andthe sale of tissues and organs, including attentionto the wider problem of international trafficking inhuman tissues and organs” (1).

To address the urgent and growing problems oforgan sales, transplant tourism and trafficking inorgan donors in the context of the global shortageof organs, a Summit Meeting of more than 150representatives of scientific and medical bodiesfrom around the world, government officials, socialscientists, and ethicists, was held in Istanbul fromApril 30 to May 2, 2008. Preparatory work for themeeting was undertaken by a Steering Committeeconvened by The Transplantation Society (TTS)and the International Society of Nephrology (ISN)in Dubai in December 2007. That committee’s draftdeclaration was widely circulated and then revisedin light of the comments received. At the Summit,the revised draft was reviewed by working groupsand finalized in plenary deliberations.

This Declaration represents the consensus of theSummit participants. All countries need a legal and

professional framework to govern organ donationand transplantation activities, as well as atransparent regulatory oversight system thatensures donor and recipient safety and theenforcement of standards and prohibitions onunethical practices.

Unethical practices are, in part, an undesirableconsequence of the global shortage of organs fortransplantation. Thus, each country should striveboth to ensure that programs to prevent organfailure are implemented and to provide organs tomeet the transplant needs of its residents fromdonors within its own population or throughregional cooperation. The therapeutic potential ofdeceased organ donation should be maximizednot only for kidneys but also for other organs,appropriate to the transplantation needs of eachcountry. Efforts to initiate or enhance deceaseddonor transplantation are essential to minimize theburden on living donors. Educational programs areuseful in addressing the barriers, misconceptionsand mistrust that currently impede thedevelopment of sufficient deceased donortransplantation; successful transplant programsalso depend on the existence of the relevanthealth system infrastructure.

Access to healthcare is a human right but oftennot a reality. The provision of care for living donorsbefore, during and after surgery–as described inthe reports of the international forums organizedby TTS in Amsterdam and Vancouver (2-4)–is noless essential than taking care of the transplantrecipient. A positive outcome for a recipient cannever justify harm to a live donor; on the contrary,for a transplant with a live donor to be regarded asa success means that both the recipient and thedonor have done well.

This Declaration builds on the principles of theUniversal Declaration of Human Rights (5). The

THE DECLARATION OF ISTANBULon Organ Trafficking and Transplant Tourism

Participants in the International Summit on Transplant Tourism and Organ Traffickingconvened by The Transplantation Society and International Society of Nephrology

in Istanbul, Turkey, April 30–May 2, 2008*


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broad representation at the Istanbul Summitreflects the importance of internationalcollaboration and global consensus to improvedonation and transplantation practices. TheDeclaration will be submitted to relevantprofessional organizations and to the healthauthorities of all countries for consideration. Thelegacy of transplantation must not be theimpoverished victims of organ trafficking andtransplant tourism but rather a celebration of thegift of health by one individual to another.

DEFINITIONS

Organ trafficking is the recruitment, transport,transfer, harboring or receipt of living or deceasedpersons or their organs by means of the threat oruse of force or other forms of coercion, of abduction,of fraud, of deception, of the abuse of power or of aposition of vulnerability, or of the giving to, or thereceiving by, a third party of payments or benefits toachieve the transfer of control over the potentialdonor, for the purpose of exploitation by the removalof organs for transplantation (6).

Transplant commercialism is a policy or practicein which an organ is treated as a commodity,including by being bought or sold or used formaterial gain.

Travel for transplantation is the movement oforgans, donors, recipients or transplant professionalsacross jurisdictional borders for transplantationpurposes. Travel for transplantation becomestransplant tourism if it involves organ traffickingand/or transplant commercialism or if the resources(organs, professionals and transplant centers)devoted to providing transplants to patients fromoutside a country undermine the country’s ability toprovide transplant services for its own population.

PRINCIPLES

1. National governments, working in collaborationwith international and non-governmentalorganizations, should develop and implementcomprehensive programs for the screening,prevention and treatment of organ failure, whichinclude:

a. The advancement of clinical and basicscience research;

b. Effective programs, based on internationalguidelines, to treat and maintain patients

with end-stage diseases, such as dialysisprograms for renal patients, to minimizemorbidity and mortality, alongside transplantprograms for such diseases;

c. Organ transplantation as the preferredtreatment for organ failure for medicallysuitable recipients.

2. Legislation should be developed andimplemented by each country or jurisdiction togovern the recovery of organs from deceasedand living donors and the practice oftransplantation, consistent with internationalstandards:

a. Policies and procedures should bedeveloped and implemented to maximize thenumber of organs available fortransplantation, consistent with theseprinciples;

b. The practice of donation and transplantationrequires oversight and accountability byhealth authorities in each country to ensuretransparency and safety;

c. Oversight requires a national or regionalregistry to record deceased and living donortransplants;

d. Key components of effective programsinclude public education and awareness,health professional education and training,and defined responsibilities andaccountabilities for all stakeholders in thenational organ donation and transplantsystem.

3. Organs for transplantation should be equitablyallocated within countries or jurisdictions tosuitable recipients without regard to gender,ethnicity, religion, or social or financial status:

a. Financial considerations or material gain ofany party must not influence the applicationof relevant allocation rules.

4. The primary objective of transplant policies andprograms should be optimal short- and long-term medical care to promote the health ofboth donors and recipients:

a. Financial considerations or material gain ofany party must not override primaryconsideration for the health and well-beingof donors and recipients.


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5. Jurisdictions, countries and regions shouldstrive to achieve self-sufficiency in organdonation by providing a sufficient number oforgans for residents in need from within thecountry or through regional cooperation:

a. Collaboration between countries is notinconsistent with national self-sufficiency aslong as the collaboration protects thevulnerable, promotes equality between donorand recipient populations, and does notviolate these principles;

b. Treatment of patients from outside thecountry or jurisdiction is only acceptable if itdoes not undermine a country’s ability toprovide transplant services for its ownpopulation.

6. Organ trafficking and transplant tourism violatethe principles of equity, justice and respect forhuman dignity and should be prohibited.Because transplant commercialism targetsimpoverished and otherwise vulnerable donors,it leads inexorably to inequity and injustice andshould be prohibited. In Resolution 44.25, theWorld Health Assembly called on countries toprevent the purchase and sale of human organsfor transplantation:

a. Prohibitions on these practices shouldinclude a ban on all types of advertising(including electronic and print media),soliciting, or brokering for the purpose oftransplant commercialism, organ trafficking,or transplant tourism.

b. Such prohibitions should also include penaltiesfor acts —such as medically screeningdonors or organs, or transplanting organs—that aid, encourage, or use the products of,organ trafficking or transplant tourism.

c. Practices that induce vulnerable individualsor groups (suchas illiterate and impoverishedpersons, undocumented immigrants,prisoners, and political or economicrefugees) to become living donors areincompatible with the aim of combatingorgan trafficking, transplant tourism andtransplant commercialism.

PROPOSALS

Consistent with these principles, participants in theIstanbul Summit suggest the following strategies to

increase the donor pool and to prevent organtrafficking, transplant commercialism andtransplant tourism and to encourage legitimate,life-saving transplantation programs:

To respond to the need to increase deceaseddonation:

1. Governments, in collaboration with health careinstitutions, professionals, and non-governmental organizations should takeappropriate actions to increase deceased organdonation. Measures should be taken to removeobstacles and disincentives to deceased organdonation.

2. In countries without established deceasedorgan donation or transplantation, nationallegislation should be enacted that would initiatedeceased organ donation and createtransplantation infrastructure, so as to fulfilleach country’s deceased donor potential.

3. In all countries in which deceased organdonation has been initiated, the therapeuticpotential of deceased organ donation andtransplantation should be maximized.

4. Countries with well established deceased donortransplant programs are encouraged to shareinformation, expertise and technology withcountries seeking to improve their organdonation efforts.

To ensure the protection and safety of livingdonors and appropriate recognition for theirheroic act while combating transplant tourism,organ trafficking and transplant commercialism:

1. The act of donation should be regarded asheroic and honored as such by representativesof the government and civil societyorganizations.

2. The determination of the medical andpsychosocial suitability of the living donorshould be guided by the recommendations ofthe Amsterdam and Vancouver Forums (2-4):

a. Mechanisms for informed consent shouldincorporate provisions for evaluating thedonor’s understanding, including assessmentof the psychological impact of the process;

b. All donors should undergo psychosocialevaluation by mental health professionalsduring screening.


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3. The care of organ donors, including those whohave been victims of organ trafficking,transplant commercialism, and transplanttourism, is a critical responsibility of alljurisdictions that sanctioned organ transplantsutilizing such practices.

4. Systems and structures should ensurestandardization, transparency and accountabilityof support for donation:

a. Mechanisms for transparency of processand follow-up should be established;

b. Informed consent should be obtained bothfor donation and for follow-up processes.

5. Provision of care includes medical andpsychosocial care at the time of donation andfor any short- and long-term consequencesrelated to organ donation:

a. In jurisdictions and countries that lackuniversal health insurance, the provision ofdisability, life, and health insurance related tothe donation event is a necessaryrequirement in providing care for the donor;

b. In those jurisdictions that have universalhealth insurance, governmental servicesshould ensure donors have access toappropriate medical care related to thedonation event;

c. Health and/or life insurance coverage andemployment opportunities of persons whodonate organs should not be compromised;

d. All donors should be offered psychosocialservices as a standard component of follow-up;

e. In the event of organ failure in the donor, thedonor should receive:

i. Supportive medical care, includingdialysis for those with renal failure, and

ii. Priority for access to transplantation,integrated into existing allocation rules asthey apply to either living or deceasedorgan transplantation.

6. Comprehensive reimbursement of the actual,documented costs of donating an organ doesnot constitute a payment for an organ, but israther part of the legitimate costs of treating therecipient:

a. Such cost-reimbursement would usually bemade by the party responsible for the costsof treating the transplant recipient (such as agovernment health department or a healthinsurer);

b. Relevant costs and expenses should becalculated and administered usingtransparent methodology, consistent withnational norms;

c. Reimbursement of approved costs should bemade directly to the party supplying theservice (such as to the hospital thatprovided the donor’s medical care);

d. Reimbursement of the donor’s lost incomeand out-of-pockets expenses should beadministered by the agency handling thetransplant rather than paid directly from therecipient to the donor.

7. Legitimate expenses that may be reimbursedwhen documented include:

a. the cost of any medical and psychologicalevaluations of potential living donors whoare excluded from donation (e.g., because ofmedical or immunologic issues discoveredduring the evaluation process);

b. costs incurred in arranging and effecting thepre-, peri- and post-operative phases of thedonation process (e.g., long-distancetelephone calls, travel, accommodation andsubsistence expenses);

c. medical expenses incurred for post-discharge care of the donor;

d. lost income in relation to donation(consistent with national norms).

REFERENCES

1. World Health Assembly Resolution 57.18,Human organ and tissue transplantation, 22May 2004, http://www.who.int/gb/ebwha/pdf_files/WHA57/A57_R18-en.pdf.

2. The Ethics Committee of the TransplantationSociety (2004). The Consensus Statement ofthe Amsterdam Forum on the Care of the LiveKidney Donor. Transplantation 78(4):491-92.

3. Barr ML, Belghiti J, Villamil FG, Pomfret EA,Sutherland DS, Gruessner RW, Langnas AN &


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Delmonico FL (2006). A Report of theVancouver Forum on the Care of the Life OrganDonor: Lung, Liver, Pancreas, and IntenstineData and Medical Guidelines. Transplantation81(10):1373-85.

4. Pruett TL, Tibell A, Alabdulkareem A, BhandariM, Cronon DC, Dew MA, Dib-Kuri A, GutmannT, Matas A, McMurdo L, Rahmel A, Rizvi SAH,Wright L & Delmonico FL (2006). The EthicsStatement of the Vancouver Forum on the LiveLung, Liver, Pancreas, and Intestine Donor.Transplantation 81(10):1386-87.

5. Universal Declaration of Human Rights,adopted by the UN General Assembly onDecember 10, 1948, http://www.un.org/Overview/rights.html.

6. Based on Article 3a of the Protocol to Prevent,Suppress and Punish Trafficking in Persons,Especially Women and Children, Supplementingthe United Nations Convention AgainstTransnational Organized Crime,http://www.uncjin.org/Documents/Conventions/dcatoc/final_ documents_2/convention_%20traff_eng.pdf.

PROCESS AND PARTICIPANT SELECTION

Steering Committee:

The Steering Committee was selected by anOrganizing Committee consisting of Mona Alrukhami,Jeremy Chapman, Francis Delmonico, MohamedSayegh, Faissal Shaheen, and Annika Tibell.

The Steering Committee was composed ofleadership from The Transplantation Society,including its President-elect and the Chair of itsEthics Committee, and the International Society ofNephrology, including its Vice President andindividuals holding Council positions. The SteeringCommittee had representation from each of thecontinental regions of the globe withtransplantation programs.

The mission of the Steering Committee was todraft a Declaration for consideration by a diversegroup of participants at the Istanbul Summit. TheSteering Committee also had the responsibility todevelop the list of participants to be invited to theSummit meeting.

Istanbul Participant Selection:

Participants at the Istanbul Summit were selectedby the Steering Committee according to thefollowing considerations:

• The country liaisons of The TransplantationSociety representing virtually all countries withtransplantation programs;

• Representatives from international societies andthe Vatican;

• Individuals holding leadership positions innephrology and transplantation;

• Stakeholders in the public policy aspect oforgan transplantation; and

• Ethicists, anthropologists, sociologists, and legalscholars well-recognized for their writingsregarding transplantation policy and practice.

No person or group was polled with respect to theiropinion, practice, or philosophy prior to the SteeringCommittee selection or the Istanbul Summit.

After the proposed group of participants wasprepared and reviewed by the Steering Committee,they were sent an letter of invitation to the IstanbulSummit, which included the following components:

• the mission of the Steering Committee to draft aDeclaration for all Istanbul participants’consideration;

• the agenda and work group format of theSummit;

• the procedure for the selection of participants;

• the work group topics;

• an invitation to the participants to indicate theirwork group preferences;

• the intent to communicate a draft and othermaterials before the Summit convened;

• the Summit goals to assemble a finalDeclaration that could achieve consensus and

The Participants in the International Summit on Transplant Tourism and Organ Traffickingand the manner in which they were chosen and the meeting was organized were as follows:


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would address the issues of organ trafficking,transplant tourism and commercialism, andprovide principles of practice andrecommended alternatives to address theshortage of organs;

• an acknowledgment of the funding provided byAstellas Pharmaceuticals for the Summit;

• provision of hotel accommodations and travelfor all invited participants.

Of approximately 170 persons invited, 160 agreedto participate and 152 were able to attend theSummit in Istanbul on April 30-May 2, 2008.Because work on the Declaration at the Summitwas to be carried out by dividing the draftdocument into separate parts, Summit inviteeswere assigned to a work group topic based ontheir response concerning the particular topics onwhich they wished to focus their attention beforeand during the Summit.

Preparation of the Declaration:

The draft Declaration prepared by the SteeringCommittee was furnished to all participants withample time for appraisal and response prior to theSummit. The comments and suggestions receivedin advance were reviewed by the Steering

Committee and given to leaders of the appropriatework group at the Summit. (Work group leaderswere selected and assigned from the SteeringCommittee.)

The Summit meeting was formatted so thatbreakout sessions of the work groups couldconsider the written responses received fromparticipants prior to the Summit as well ascomments from each of the work groupparticipants. The work groups elaborated theseideas as proposed additions to and revisions ofthe draft. When the Summit reconvened in plenarysession, the Chairs of each work group presentedthe outcome of their breakout session to allSummit participants for discussion. During thisprocess of review, the wording of each section ofthe Declaration was displayed on a screen beforethe plenary participants and was modified in lightof their comments until consensus was reached oneach point.

The content of the Declaration is derived from theconsensus that was reached by the participants atthe Summit in the plenary sessions which tookplace on May 1 and 2, 2008. A formatting groupwas assembled immediately after the Summit toaddress punctuation, grammatical and relatedconcerns and to record the Declaration in itsfinished form.

Abboud Omar Sudan*Abbud-Filho Mario BrazilAbdramanov Kaldarbek KyrgyzstanAbdulla Sadiq BahrainAbraham Georgi IndiaAbueva Amihan V. PhilippinesAderibigbe Ademola Nigeria*Al-Mousawi Mustafa KuwaitAlberu Josefina MexicoAllen Richard D.M. AustraliaAlmazán-Gómez Lynn C. PhilippinesAlnono Ibrahim Yemen*Alobaidli Ali Abdulkareem United Arab Emirates*Alrukhaimi Mona United Arab EmiratesÁlvarez Inés UruguayAssad Lina Saudi ArabiaAssounga Alain G. South AfricaBaez Yenny Colombia*Bagheri Alireza Iran*Bakr Mohamed Adel EgyptBamgboye Ebun Nigeria*Barbari Antoine Lebanon

Belghiti Jacques FranceBen Abdallah Taieb TunisiaBen Ammar Mohamed Salah TunisiaBos Michael The NetherlandsBritz Russell South AfricaBudiani Debra USA*Capron Alexander USACastro Cristina R. Brazil*Chapman Jeremy AustraliaChen Zhonghua Klaus People’s Republic of ChinaCodreanu Igor MoldovaCole Edward CanadaCozzi Emanuele Italy*Danovitch Gabriel USADavids Razeen South AfricaDe Broe Marc Belgium*De Castro Leonardo Philippines*Delmonico Francis L. USADerani Rania SyriaDittmer Ian New ZealandDomínguez-Gil Beatriz SpainDuro-García Valter Brazil

Last Name First Name Country Last Name First Name Country

PARTICIPANTS IN THE ISTANBUL SUMMIT


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Ehtuish Ehtuish LibyaEl-Shoubaki Hatem QatarEpstein Miran United Kingdom*Fazel Iraj IranFernández Zincke Eduardo BelgiumGarcía-Gallont Rudolf GuatemalaGhods Ahad J. IranGill John CanadaGlotz Denis FranceGopalakrishnan Ganesh IndiaGracida Carmen MexicoGrinyo Josep SpainHa Jongwon South Korea*Haberal Mehmet A. TurkeyHakim Nadey United KingdomHarmon William USAHasegawa Tomonori JapanHassan Ahmed Adel EgyptHickey David IrelandHiesse Christian FranceHongji Yang People’s Republic of ChinaHumar Inés CroatiaHurtado Abdias PeruIsmail Moustafa Wesam EgyptIvanovski Ninoslav Macedonia*Jha Vivekanand IndiaKahn Delawir South AfricaKamel Refaat EgyptKirpalani Ashok IndiaKirste Guenter Germany*Kobayashi Eiji JapanKoller Jan SlovakiaKranenburg Leonieke The Netherlands*Lameire Norbert BelgiumLaouabdia-Sellami Karim FranceLei Ruipeng People’s Republic of China*Levin Adeera CanadaLloveras Josep SpainLõhmus Aleksander EstoniaLuciolli Esmeralda FranceLundin Susanne SwedenLye Wai Choong SingaporeLynch Stephen Australia*Maïga Mahamane MaliMamzer Bruneel Marie-France FranceMaric Nicole Austria*Martin Dominique Australia*Masri Marwan LebanonMatamoros Maria A. Costa RicaMatas Arthur USAMcNeil Adrian United KingdomMeiser Bruno GermanyMeši Enisa BosniaMoazam Farhat Pakistan

Mohsin Nabil OmanMor Eytan IsraelMorales Jorge ChileMunn Stephen New ZealandMurphy Mark Ireland*Naicker Saraladevi South AfricaNaqvi S.A. Anwar Pakistan*Noël Luc WHOObrador Gregorio MexicoOliveros Yolanda PhilippinesOna Enrique PhilippinesOosterlee Arie The NetherlandsOyen Ole NorwayPadilla Benita PhilippinesPratschke Johann GermanyRahamimov Ruth IsraelRahmel Axel The NetherlandsReznik Oleg Russia*Rizvi S. Adibul Hasan PakistanRoberts Lesley Ann Trinidad and Tobago*Rodriguez-Iturbe Bernardo VenezuelaRowinski Wojciech PolandSaeed Bassam SyriaSarkissian Ashot Armenia*Sayegh Mohamed H. USAScheper-Hughes Nancy USASever Mehmet Sukru Turkey*Shaheen Faissal A. Saudi ArabiaSharma Dhananjaya IndiaShinozaki Naoshi JapanSimforoosh Nasser IranSingh Harjit MalaysiaSok Hean Thong CambodiaSomerville Margaret CanadaStadtler Maria USA*Stephan Antoine LebanonSuárez Juliette CubaSuaudeau Msgr. Jacques ItalySumethkul Vasant ThailandTakahara Shiro JapanThiel Gilbert T. Switzerland*Tibell Annika SwedenTomadze Gia Georgia*Tong Matthew Kwok-Lung Hong KongTsai Daniel Fu-Chang TaiwanUriarte Remedios PhilippinesVanrenterghem Yves F.C. Belgium*Vathsala A. SingaporeWeimar Willem The NetherlandsWikler Daniel USAYoung Kimberly CanadaYuldashev Ulugbek UzbekistanZhao Minggang People’s Republic of China

* = Members of the Steering Committee. (William Couser, USA, was also a member of the Steering Committee but was unable to attend the Summit.)

Last Name First Name Country Last Name First Name Country


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LIST OF PARTICIPANTS CD-P-TO(16-17/10/08, Strasbourg)

AUSTRIADr. MUEHLBACHER FerdinandBELGIUMDr. COENE LeenBULGARIADr. BRANKOV DimitarCYPRUSCZECH REPUBLICDr. BREZOVSKY PavelDENMARKESTONIADr. DMITRIEV PeeterFINLANDDr. SALMELA KaijaFRANCEDr. LAOUABDIA-SELLAMI KarimGERMANYDr. KIRSTE GünterGREECEDr. GOMBOU AthinaHUNGARYDr. PERNER FerencIRELANDITALYDr. NANNI COSTA AlessandroDr. RAGO ClaudioLATVIALITHUANIALUXEMBOURGDr. MOUSTY RaymondMALTANETHERLANDSDr. HAASE-KROMWIJK BernadettePOLANDDr. ROWINSKI WojciechPOTUGALDr. FRANCA Ana REPUBLIC OF MOLDOVADr. CODREANU IgorROMANIADr. ZOTA VictorSLOVENIADr. AVSEC- LETONJA DanicaSPAINDr. MATESANZ RafaelDr. DOMINGUEZ-GIL BeatrizSLOVAK REPUBLICSWEDENDr. ERICZON Bo-GöranUNITED KINGDOM

(ET) EUROTRANSPLANT Austria, Belgium, Croatia, Germany, Luxemburg,Netherlands, SloveniaDr. OOSTERLEE Arie Dr. RAHMEL Axel(SKT) SCANDIATRANSPLANTDenmark, Finland, Norway, Sweden, Iceland Dr. JAKOBSEN Arnt

ARMENIABELARUSBOSNIA AND HERZEGOVINACANADADr. AGBANYO FranciscaCROATIADr. KOCMAN BranislavGEORGIAICELANDISRAELDr. ASHKENAZI TamarNORWAYDr. PFEFFER PerRUSSIAN FEDERATIONSERBIA SWITZERLANDDr. MOREL PhilippeTURKEY

UNOSDr. PRUETT Timothy

IBEROAMERICAN COUNCILDr. MORALES BELLINI Fernando

CDBIGARANI-PAPADATOS StamatiaDr. DE SOLA LLERA CarlosDr. GORSETH HallvardDr. LWOFF LaurenceDr. REQUENA MartaDr. SPIESER Jean-Marc (Head of DBO)M-E. BEHR-GROSS (Secretariat)

EUROPEAN COMMISSIONDr. FERNANDEZ-ZINCKE Eduardo

WHO

